Multiple MRI sequences are utilized to visualize the prostate gland.  We can measure the extent of a tumor, identify the location of the tumor(s), and determine if a tumor has spread beyond the prostate gland.  A multiparametric MRI exam uses three separate MRI sequences:

• T2 weighted images: T2 weighted images give clear images of your anatomy and will show any suspicious areas in the prostate.
• Diffusion weighted images: These images attempt to demonstrate the movement of water molecules through prostate tissue, which helps pinpoint areas of abnormal (cancerous) cells.
• Dynamic Contrast-enhanced: DCE allows for imaging of the vasculature as well as perfusion in the prostate gland to find an area of abnormal blood flow that may represent the tumor.

Symptoms of Prostate Cancer can include, but are not limited to:

• Frequent, hesitant, and burning urination
• Blood in the semen
• Erectile dysfunction
• Bone pain or pain/stiffness in the lower back, hips, or upper thighs

Because these symptoms can also indicate the presence of other disease(s), a complete medical workup may be needed to determine the underlying cause of these symptoms.

Prostate cancer can be suspected with a combination of the PSA blood test and a digital rectal exam (DRE). Sometimes a prostate biopsy is indicated if these tests are abnormal. In many cases, a specialized contrast enhanced MRI examination may be performed (Multiparametric Prostate MRI).  These MRI studies are read by fellowship-trained Abdominal radiologists with additional subspecialty training in prostate MRI and help decrease the number of biopsies performed while increasing the number of significant prostate cancers identified.

There are a variety of treatment options available including surgery, radiation therapy, cryotherapy, proton therapy, hormone therapy, and chemotherapy. If prostate cancer is considered low risk, it can be monitored with the active surveillance protocol. Active surveillance means MRI Prostate examinations on an interval determined by your treating physician but without any aggressive treatments or surgeries. This is to ensure the cancer remains low risk over time, and patients avoid the high risk and side effects associated with surgery and chemotherapy.

Sometimes more aggressive treatments like prostatectomy and radiation therapy may be indicated. However, these cancers would be clearly identified by the Prostate MRI examination and would assist the treatment planning by urologists, radiation oncologists, and the oncologists.

The spread of prostate cancer is suspected if the PSA begins to rise after treatment has occurred or if the PSA is very high at diagnosis.  Sometimes a bone scan can be utilized to identify if the cancer has spread to the bones. However, the PSMA PET/CT scans have recently become available and are the most advanced and state of the art study available to detect if the cancer has spread and detect metastasis at a much earlier stage.